Seychelles has the highest percentage of vaccinated people per capita. Nonetheless the nation is currently dealing with a surge in COVID-19 cases. It does not have the world's biggest surge, in terms of total cases or as a percentage of its population.

As of May 18, 2021, over 60% of the Seychelles' population has been fully vaccinated, and more than 70% of the population has received their first injection. The island nation has vaccinated a higher proportion of its population against coronavirus than any other country. Nonetheless, over 10% of the total Seychelles population has been infected with the virus, resulting in 38 deaths and a recent surge in cases.

More than half of the Seychelle's vaccinations used the Sinopharm vaccine (57%) and 43% used Covishield (the AstraZeneca-Oxford vaccine). It is not known which vaccines have been given to those who later had a positive COVID-19 test.

The Sinopharm vaccine has been demonstrated to be 79% effective at preventive symptomatic and hospitalized cases of COVID-19. Covishield was shown to be 76% effective at preventing symptoms and 100% effective in preventing hospitalizations.

The significant number of new cases in fully vaccinated people in Seychelles has raised questions about how effective the vaccines may be in real world settings. It also raises questions about whether the vaccines may have been spoiled in transport.

It is important to note that while a third (37%) of new active infections in Seychelles were in people who are vaccinated, none of the vaccinated patients died. A large number of hospitalized patients — 80%— were unvaccinated. Many had underlying medical conditions. A large majority of the vaccinated people who tested positive for the virus had mild, moderate, or no symptoms.

Considering the country has 115 islands and a population of 100,000 people, the recent peak of 400 daily cases has caused significant alarm for the country's health leaders. Some potential reasons for the increase in cases among vaccinated people include:

• More relaxed national prevention measures
• Increases in unvaccinated tourists
• Infections occurring after a first or second shot but before the vaccine reaches its full effectiveness
• Herd immunity has not been reached as just over 70% of the population has been vaccinated (i.e. The vaccines are not effective enough to achieve herd immunity at a level that low)
• Issues with cold chain storage, transportation, logistics, and distribution that made the vaccines ineffective
• Higher efficacy vaccines may be needed
• Variants are spreading in the country which may be more infectious than others circulating around the world and more able to evade the vaccine's protection
• The Sinopharm vaccine did not have as much data about people over 60 as other vaccines, so it may be less effective in this population

More specific research about vaccinated people who tested positive for COVID-19 is needed to determine the cause of the rise in cases.

The small island nation off the coast of East Africa is facing a devastating wave in cases, though the total number of cases in the country is hundreds of thousands lower than in other countries.